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General NPI Number Information
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NPI Number | 1558233627
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Entity Type | Organization
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Legal Business Name | JAVIER ALFONSO DE LA CRUZ, PLLC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 12611 BONITA BEACH RD, SUITE #3
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City | BONITA SPRINGS
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State | FL
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Zip | 34134
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Country | US
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Telephone | 239-488-1313
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Fax | 239-488-1033
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Provider Business Mailing Address
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Address Line | 14025 HAWKS EYE CT
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City | ESTERO
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State | FL
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Zip | 33928-9153
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Country | US
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Telephone | 407-927-3788
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | JAVIER ALFONSO DE LA CRUZ
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Credential | DMD
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Telephone | 407-927-3788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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